A 31-year-old male with a history of stab wound in the left costal margin (axillary midline) for approximately 15 years, not requiring surgical treatment and without apparent sequelae.
The patient came to the emergency room with a 24-hour history of malaise, diffuse abdominal colic pain, associated with nausea and vomiting.
Physical examination revealed disorientation, abdominal tympanism, predominantly left.
No significant blood test findings.
Abdominal X-ray showed dilation of the ascending and transverse colon, with cecal diameter of 10-11 centimeters.
Abdominal CT was requested to report the presence of a left diaphragmatic hernia containing a transverse colon loop, conditioning the recessive condition.
Emergency surgery was decided (exploratory midline laparotomy). A left diaphragmatic hernia with a 5 cm diameter orifice containing transverse colon (25 centimeters) and omentum correctly perfused was observed. A reduction of the hernia was achieved.
Postoperative period was uneventful.
